摘要
目的探讨心肌超声造影(MCE)对冠心病心肌缺血的微循环灌注的评估价值。方法选取2017年1月至2018年12月郑州市中心医院40例冠心病病人(观察组)及同期年龄相匹配的健康志愿者20例(对照组)进行MCE检查,对两组左心室心肌节段微循环灌注进行定量分析,记录其MECE灌注参数(A值、β值、A×β值)。结果观察组、对照组分别纳入495个、287个心肌节段,观察组A值、β值、A×β值低于对照组(P<0.05);观察组中室壁运动异常者112个,无室壁运动异常者383个,室壁运动异常组心肌节段灌注参数A值、β值及A×β值均明显小于无室壁运动异常组(P<0.05)。根据冠脉狭窄程度进行分组分析,冠脉狭窄<50%组、冠脉狭窄50%~69%组心肌节段A值、β值及A×β值对比均差异无统计学意义(P>0.05),而冠脉狭窄70%~89%组A×β值明显小于其冠脉狭窄<50%组及冠脉狭窄50%~69%组(P<0.05),且冠脉狭窄≥90%组A值、β值及A×β值均明显小于其他各冠脉狭窄程度组(P<0.05)。ROC曲线分析显示,A×β值预测重度冠脉狭窄(狭窄≥70%)的曲线下面积为0.812(95%CI:0.786~0.842),截断值为1.06 dB/s,敏感度为86.7%,特异度为80.5%。结论MCE可定性、定量评价冠心病心肌缺血的微循环灌注情况,显示冠脉狭窄所造成左室心肌微循环损伤程度。
Objective To explore the evaluated value of myocardial contrast echocardiography(MCE)on microcirculation perfusion of coronary heart disease with myocardial ischemia.Methods MCE examination was performed on 40 patients with coronary heart disease(observation group)and 20 healthy volunteers of matching age(control group)in Zhengzhou Central Hospital form January 2017 to December 2018,and quantitative analysis was performed on microcirculation perfusion of left ventricular myocardial segments,and the MECE perfusion parameters(A value,βvalue,A×βvalue)were recorded.Results Totally 495 and 287 myocardial segments were included in observation group and control group respectively,and the A value,βvalue and A×βvalue in observation group were lower than those in control group(P<0.05).There were 112 patients with abnormal ventricular wall motion and 383 without abnormal ventricular wall motion in observation group,and the myocardial segment perfusion parameters of A value,βvalue and A×βvalue in abnormal ventricular wall motion group were significantly lower than those in non-abnormal ventricular wall motion group(P<0.05).According to coronary stenosis degree for grouping and analysis,there were no significant differences in the A value,βvalue and A×βvalue between coronary stenosis<50%group and 50%-69%coronary stenosis group(P>0.05),and the A×βvalue in 70%-89%coronary stenosis group was significantly lower than that in coronary stenosis<50%group and 50%-69%coronary stenosis group(P<0.05),and the A value,βvalue and A×βvalue in coronary stenosis≥90%group were significantly lower than those in other coronary stenosis groups(P<0.05).ROC curve analysis showed that the area under the curve,cutoff value,sensitivity and specificity were 0.812(95%CI:0.786-0.842),1.06 dB/s,86.7%and 80.5%for A×βvalue in predicting severe coronary stenosis(stenosis≥70%).Conclusion MCE can qualitatively and quantitatively evaluate the microcirculation perfusion of coronary heart disease with myocardial ischemia,and show the left ventricular myocardial microcirculation injury caused by coronary stenosis.
作者
张晓丽
闫媛媛
ZHANG Xiaoli;YAN Yuanyuan(Department of Ultrasound Medicine,Zhengzhou Central Hospital,Zhengzhou,Henan 450000,China)
出处
《安徽医药》
CAS
2021年第8期1533-1536,共4页
Anhui Medical and Pharmaceutical Journal
基金
河南省医学科技攻关计划项目(201702312)。
关键词
冠心病
心肌超声造影
心肌缺血
微循环灌注
Coronary heart disease
Myocardial contrast echocardiography
Myocardial ischemia
Microcirculation perfusion
